New method of internal fixation in laparoscopic Tenckhoff catheter placement

Abstract

Background Despite obvious advantages of peritoneal dialysis (PD), mechanical complications are responsible for the failure of PD at early stage. Suture fixation in laparoscopic PD catheter method could reduce mechanical complications. In our study, a simple method to fix PD catheter was developed. Methods Tenckhoff catheter placement was performed in 49 consecutive patients. In the technique, only two trocars were used. With the help of syringe needle and forceps, a loop of silk was prepared at the abdominal wall. The PD catheter was thread through the loop. The silk ligature was tied subcutaneously keeping the catheter suspended from the abdominal wall. Primary outcomes were catheter‐related complications. Secondary outcomes were 6‐month catheter survival rates and death within 30 days. Data were analyzed retrospectively. Results The average operation time was 49.7 ± 15.8 min. Minimum follow‐up time was 6 months. No catheter displacement or hernia was detected. One patient had omental wrapping after silk suture rupture, 2 patients had outflow obstruction, and 3 patients had leakage. No one died within 30 days postoperatively. Catheter survival was 95.8% at 6 months. Conclusions The method we described greatly reduced the risk of catheter displacement and omental wrap. Also, the required instrument and laparoscopic skill were simple.

Suture passer combined with two-hole laparoscopic peritoneal dialysis catheterization in patients undergoing peritoneal dialysis

“…The two-hole laparoscopic PDC placement technique utilized in this study enables direct visualization of the abdominal cavity, allowing for auxiliary surgeries such as adhesiolysis, omentopexy, and catheter fixation. Simultaneously, the two surgical incisions lead to lesser abdominal damage to patients than basic laparoscopy and offer significant advantages in terms of abdominal wall leakage [ 18 ] and abdominal esthetics. Another noteworthy advantage of our surgery is that the laparoscope observation hole is created 5-cm above the navel, avoiding the navel as an observation hole can prevent umbilical hernia and leakage.…”

Research on comprehensive analysis of patient comfort and complication rate using haemodialysis indwelling needles in AVF puncture in haemodialysis treatment

“…Additionally, appropriate puncture tools are of great significance in reducing puncture complications, prolonging the service life of internal fistulas, reducing the failure rate of internal fistula establishment and the patient readmission rate. 20 , 21 Suitable puncture tools can also reduce the workload of nursing staff and ensure the quality of care and work efficiency. Our analysis suggests that dialysis indwelling needles reduces pain and patient discomfort.…”